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Individual

ANGELA LEIGH SELSETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
2000 NORTH AVE, NORTHFIELD, MN 55057-1498
(507) 646-8800
Mailing address
23076 LEWISTON BLVD, HAMPTON, MN 55031-9744

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1791
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
069802701
NATABOC
01
1791
BMP-MN
Enumeration date
06/20/2008
Last updated
06/20/2008
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